Objective To study the multi-slice spiral CT (MSCT) perfusion imaging in evaluating the changes of blood supply of hepatocellular carcinoma( HCC ) before and after transcatheter hepatic arterial chemoembolization (TACE). Methods Before and after TACE, MSCT perfusion was performed in 17 patients with HCC. The perfusion indexes such as hepatic blood flow (HBF), hepatic blood volume(HBV),mean transit time (MTT),hepatic arterial fracture (HAF),permeability surface (PS), hepatic artery perfusion (HAP), portal venous perfusion (PVP) were calculated. The hemodynamic changes of HCC after TACE were evaluated according to perfusion parameters. Results After TACE, HBF,HBV and HAP found in MTT and PS before and after TACE (P > 0.05). Conclusion The parameters of MSCT perfusion imaging( HBF, HBV and HAP) can effectively evaluate the hemodynamic changes of HCC after TACE, and has important value in chnical application.

Objective To investigate the characteristics of hepatitis C viurs (HCV)infection and its genotypes in Yancheng area . Methods A total of 20 185 cases of subjects receiving healthy examination were collected ,and fasting blood levels of serum anti‐HCV were detected .Clinical data of patients with HCV infection were statistically analysed .HCV genotypes and levels of HCV RNA were detected ,and their clinical prognosis was judged by type‐B ultrasonic .Results The total infection rate of HCV was 1 .22% .The infection rate of male was higher than that of female and the infection rate was increased with the elevation of age .The genotype 1b was accounted for 73 .17% .The results of type‐B ultrasonic shown that all patients infected with genotype 6 and 1b/2a HCV only had liver damage .80 .77% of patients infected with genotype 2a HCV had liver damage ,which was higher than that of patients infected with 16 and 3a+3b genotypes .Conclusion Most of HCV infected patients are male ,and the infection rate might be increased with the elevation of age .The prognosis is in various different genotypes of HCV ,which indicates that the prognosis could be evaluated by genotyping .

Objective To investigate the expression of interleukin 18 (IL-18) in liver tissues of patients with chronic hepatitis B (CHB) and its clinical significance.Methods Totally 172 CHB patients admitted in the Second Affiliated Hospital of Anhui Medical University from January 2012 to December 2012 were enrolled.The tissue specimens were obtained by liver biopsy from all patients,and 22 normal liver specimens were also collected as controls.Liver function,serum markers of HBV and HBV DNA load were measured and liver inflammation grades and fibrosis stages were assessed.Immunohistochemical method was used to detect the expression of IL-18 in liver tissues.Spearman rank correlation was used to analyze the correlations between IL-18 expression and the above indicators.Results IL-18 was mainly expressed in cytoplasm of liver cells.It was positive or strong positive in liver cells of healthy people,but weakly positive in liver cells of CHB patients.The difference of IL-18 expression between CHB patients and healthy people was of statistical significance (x2 =42.124,P ＜ 0.05).In CHB patients,the expression of IL-18 was gradually enhanced with the increasing of ALT,inflammation grades and fibrosis stages (r =0.182,0.173 and 0.068,P ＜0.05),but it was not correlated with HBV DNA load and HBeAg (r =-0.05 and 0.041,P ＞0.05).Conclusion In CHB patients,the expression of IL-18 may be involved in liver injury and fibrosis formation.

Objective To explore the effects of directive game in preoperative visit of preschool children with strabismus.Methods 109 children were randomly assigned into the control group and the experimental group.The control group was given conventional preoperative interview,based on the general preoperative visit,the experimental group was given preoperative visit-playing directive game.The nursing effect was compared be4wecn two groups.Results Induction compliance scores of the experimental group were obviously higher than those of the control group.Preoperative anxiety scores of the experimental group were obviously lower than those of the control group.Restlessness during recovery of the experimental group was obviously lower than that of the control group.Conclusions The application of directive game can reduce preoperative anxiety of the children with strabismus,and make children cooperate better with the induction of anesthesia.

Objective To investigate the prognosis of two decompression approaches for cervical spondylotic myelopathy. Methods 86 cases were divided into two groups. 40 cases were underwent decompression by anterior decompression, fusion and internal fixation with titanium screws and plate and 46 cases underwent posterior single opendoor laminoplasty. To investigate the prognosis of two decompression approaches for single compressive segment, two compressive segments, three compressive segments and four compressive segments. Results All cases were followed up for 20 ～ 73 months with an average of 43 months. The mean JOA recovery rate was significant different between single compressive segment group (P ＜ 0.05), and no significant difference between two compressive segments and three compressive segments(P ＞ 0.05), and significant difference between four compressive segments groups (P ＜0.05). Conclusion For single compressive segment, the anterior surgery has a good surgical result,for two or three compressive segments, anterior and posterior surgery had same effect, for the four compressive segments, posterior surgical effect was good.

Objective To investigate the visual spatial attention of occipital stroke patients with hemianopia during the acute phase.Methods Eight occipital stroke patients with homonymous hemianopia of left side in the acute stage and 10 age-matched healthy controls were recruited to examine the capability of visual spatial attention.The cue-target paradigms were applied in this behavioral research.Results In the repeated measures analysis of variance,the difference of group and cue range had distinct main effect in reaction time and accuracy rate,while the difference of target location only had main effect in reaction time.Compared with the control group,the patients exhibited longer reaction time ((1 628.26 ± 183.97) ms vs (839.79±61.29) ms,F(1,16) =163.706,P＜0.05) and lower accuracy rate (73.40％ ±3.12％ vs 92.99％ ±0.76％,F(1,16) =371.850,P ＜ 0.05).The patients displayed lower accuracy rate under large cue than small cue (71.38％ ±3.35％ vs 75.42％ ±4.23％,F(1,7) =6.706,P ＜0.05),while that of healthy controls did not vary under different cue range(93.01％ ± 0.50％ vs 92.96％ ± 1.42％,F(1,9) =0.010,P ＞ 0.05).The patients showed longer reaction time in blind-side target than healthy-side target ((1 664.17±196.57) msvs (1 594.35±174.45) ms,F(1,7) =14.157,P＜0.05),while that of control group in two target location had no statistically significant difference ((839.67 ± 60.41) ms vs (839.91 ±73.54) ms,F(1,9) =0.000,P ＞0.05).Furthermore,the mean reaction time of stroke patients had a negative correlation with the binocular vision field index (r =-0.824,P ＜ 0.05).Conclusions The extent of vision field loss in occipital stroke patients with hemianopia can reflect impairment of visual spatial attention during the acute phase.The rehabilitation training should emphasize promoting recovery of visual spatial attention in the blind side under large cue.

Objective To observe the clinical efficacy of Yu’s meridian detection and treatment plus acupuncture in treating facial paralysis.Method Sixty patients with facial paralysis in acute stage were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by Yu’s meridian detection and treatment plus acupuncture, while the control group was by ordinary acupuncture. The House-Brackmann (H-B) scale and symptom-sign scores were observed before and after the treatment.Result The H-B scale scores were changed significantly in the two groups after the treatment (P<0.05). After the treatment, the H-B score of the treatment group was significantly different from that of the control group (P<0.05). The symptom-sign scores were significantly changed in both groups after the treatment (P<0.01). The symptom-sign score of the treatment group was significantly different from that of the control group after the treatment (P<0.05).Conclusion Yu’s meridian detection and treatment plus acupuncture is an effective method in treating facial paralysis.

Objective To investigate the maternal attitude and demands for Institute of Postpartum Care in order to provide targeted services.Methods 285 women were a investigated about maternal attitude and demands towards Institute of Postpartum Care with self-designed questionnaire.Results 97.9％ (279/285) women thought sitting the month (puerperal period) was very important,50.2％ (143/285)women were interested in Institute of Postpartum Care.They thought the main three advantages were energy saving,medical expertise and technology and avoidance of family conflicts;The three major issues were high price,lack of monitoring mechanism and unfamiliar environment and less family company;33 items of services demands over four points accounted for 78.6％,the three modules with highest scores were cleaning services scored 4.64±0.47,newborn services scored 4.45±0.41,consultation service scored 4.41:±0.53.Conclusions Professional postnatal care services have been a trend and social need,and a large proportion of women have great interest and demand on Institute of Postpartum Care which should make full use of its concentrate resources,and provide specific services according to maternal demands for services.It is urgent to build unified service standards and evaluation indicators to improve service quality.

Objective To evaluate the role of Toll-like receptor 4 (TLR4) in mechanical ventilation-induced activation of microglias in the hippocampi of mice.Methods Forty-two healthy male TLR4 gene knocked out C57BL/10ScNJNju mice and 42 wild type C57BL/6 mice,aged 10-12 weeks,weighing 20-25 g,were used in the study.The mice of either group were divided into 2 subgroups (n =21 each) using a random number table:spontaneous breathing subgroup (subgroup SB) and mechanical ventilation subgroup (subgroup MV).In subgroup SB,the mice were exposed to isoflurane for 6 h in an anesthesia chamber.After tracheal intubation,the mice were mechanically ventilated for 6 h when anesthesia was maintained with isoflurane in subgroup MV.Twelve mice were selected from each subgroup at 1 and 3 days after ventilation,fear conditioning test was performed to assess the cognitive function,and the rate of freezing time was recorded.Three mice in each subgroup were sacrificed at 1 day after ventilation,and the brains were removed to observe the morphological changes of microglias (by double immunofluorescent staining) and to count CD11b positive cells and co-expression of TLR4 with CD11b (TLR4/CD11b) positive cells in hippocampal microglias.Six mice in each subgroup were sacrificed at 1 day after ventilation,and the hippocampi were isolated for determination of the content of tumor necrosis factor-alpha (TNF-α) in hippocampal tissues by enzyme-linked immunosorbent assay.Results Compared with subgroup SB of wild type group,the rate of freezing time was significantly decreased at 1 and 3 days after ventilation,and the number of CD1 1b positive cells and TLR4/CD1 1b positive cells were increased,and the content of TNF-α was increased in subgroup MV of wild type group (P＜0.05),and the number of CD1 1b positive cells and content of TNF-α were significantly increased in subgroup MV of geue knockout group (P＜0.05).Compared with subgroup SB of gene knockout group,the rate of freezing time was significantly decreased at 1 and 3 days after ventilation,and the number of CD1 1b positive cells and content of TNF-α were increased in subgroup MV of gene knockout group (P＜0.05).Compared with subgroup MV of wild type group,the rate of freezing time was significantly increased at 1 and 3 days after ventilation,and the number of CD11b positive cells and content of TNF-α were decreased in subgroup MV of gene knockout group (P＜0.05).Conclusion The mechanism by which mechanical ventilation induces activation of microglias in hippocampi is partially related to TLR4 in mice.

Objective To investigate the efficacy of combining ultrasonic with three-dimensional imaging guided microwave ablation in treating large hepatocellular carcinoma.Method The clinical data of 262 patients with large unresectable liver cancer who were admitted to the Air Force General Hospital from Jan 2011 to Jun 2014 were retrospectively analyzed.Of these patients,136 underwent transcatheter arterial chemoembolization (TACE),and the remaining 126 patients underwent combined ultrasonic with three-dimensional imaging guided microwave ablation (MWA).The AFP levels,tumor ablation rate,postoperative complication rates and survival rates between the two groups were compared.Result There were significant differences in the AFP levels in the two groups before and after surgery (P ＜0.05),but no significant differences were found between the 2 groups (P ＞ 0.05).A significant difference was also observed on tumor ablation rate.In the MWA group,11 patients (8.73％) developed complications,while 21 patients (15.44％) in the TACE group developed complications,(P ＜ 0.05).The 3-month,9-month,1-year,2-year and 3-year survival rates were 99％,95％,81％,70％ and 57％ in the MWA group,and 98％,94％,63％,36％ and 28％ in the TACE group.There were significant differences in the 1-year,2-year and 3-year survival rates,but no significant difference were observed in the 3-month and 9-month survival rates.Conclnsion Combined ultrasonic with three-dimensional imaging guided microwave ablation increased the rate of tumor ablation and prolonged the survival time of patients with large hepatocellular carcinoma.